Access to Health Care Trends

The percentage of uninsured children nationally was unchanged from 2004 to 2008.

In 2009, congress enacted a $33 billion expansion of the State Children’s Health Insurance Program (SCHIP).

The SCHIP expansion is expected to cut the number of uninsured children nearly in half by 2014 and boost the number covered by SCHIP to 11 million.

The percentage of children who don’t have health insurance coverage dropped dramatically between 2004 and 2008 in Franklin County.

*Estimated percent of children with no health insurance coverage the week prior to being surveyed.

Sources: Ohio Family Health Survey, 2004 and 2008.

Medical Insights

“Having insurance does not equate to getting service. The issue now is how to ensure children have access to care. Each year, Nationwide Children’s looks at census data, Medicaid data, and data from visits to our ER and urgent care facilities to identify geographic pockets where services are needed. We can then determine where to locate new primary care centers and deploy our mobile health care units. For example, late this fall we will take our new mobile unit, thanks to a Ronald McDonald House Foundation grant, to underserved areas in Franklin County and southeast Ohio.”

Olivia W. Thomas, MD, is the section chief of ambulatory pediatrics at Nationwide Children’s Hospital and clinical professor of pediatrics and chief of the division of ambulatory pediatrics in the department of pediatrics at The Ohio State University College of Medicine.

Health Care Insecurity Grips
Self-employed Single Mom

For the past nine years, Sheryl Wharton has been providing child care from 6:00 a.m. to 6:30 p.m., Monday through Friday. Her health care coverage hasn’t been nearly that dependable.

The ups and downs in Sheryl’s occupation are reflected in her eligibility for health insurance coverage. When she has more children to watch, she earns too much to get Medicaid coverage.

The higher income does not allow Sheryl to get ahead. She is a single mom of two children who have chronic health conditions. Her son has high blood pressure and her daughter, who this year is no longer a dependent, has asthma. “There have been times when I thought about quitting work in order to have health insurance,” says Sheryl. “But then I wouldn’t be able to afford anything else.”

Health care insecurity has forced Sheryl to make frightening choices. She has had to keep sick children from the doctor, they have used “leftover” medication, and Sheryl routinely goes without needed care. “If one of my children was very sick, I took them to the emergency room. Doing that ruined my credit because I could not easily pay.”

When Sheryl has health care coverage, it means her business is not doing as well and her income is suffering. But when her business is healthy, keeping her family well just gets harder.

Community Insights

“Ohio’s commitment to expanding Medicaid coverage for children largely accounts for the drop in the uninsured rate. But in 2005, the state reduced eligibility for their parents. Children of uninsured parents are less likely to get regular, consistent care, which is what children need, especially children with chronic health conditions. National health care legislation promises to expand coverage for parents of low income children by 2014. Still, we need to make it easier for children to get health care when their parents cannot afford to miss work. Ohio also needs to expand coverage to immigrant residents by drawing down federal matching funds for Medicaid eligible immigrant children and adults.”

Cathy Levine is the executive director of the Universal Healthcare Action Network of Ohio.